| NPI | 1346498607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 047873) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL ps 37141) |
| Enumeration Date | 2008-08-28 |
| Last Update Date | 2020-02-20 |